Preoperative ultrasound guided needle localisation for non-palpable breast lesions

Breast cancer is a major cause of cancer-related morbidity and mortality in Indian women. Most cases present late and thus survival in Indian patients is poor compared to the western world. In the absence of a screening, early detection of breast cancer is a challenge in Indian subcontinent.

Though much is known about management of any palpable lump in breast, clear guidelines in dealing with non-palpable lesions of breast is still obscure. Careful imaging of breast followed by assignment of standard Breast Imaging Reporting and Data Systems (BIRADS) category to the finding can go in a long way to predict chances of malignancy in a non-palpable breast lesion (NPBL). Total 22 patients with impalpable lesions in the breast were localised with US guided needle and lesion excised. Applicability of Ultrasonography (USG) to detect early breast lesions and comparison with mammography in predicting malignancy was assessed by tests of proportions (z test).

Total of three early breast cancers and four borderline lesions were diagnosed by this method among 22 properly selected cases. Needle localisation of the lesion on sonographic guidance followed by lumpectomy can be both an accurate diagnostic and therapeutic method to deal with occult lesion in our scenario.

US guided lumpectomy is a feasible alternative to other methods and is effective in Indian scenario to diagnose early subclinical breast cancers.